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ePaper created 2016-01-26, 09:24:16 | version 1.38.0
I opinion _ 3-D technology The examples presented will clearly display the powerful advantages that 3-D images give the clinician and in my opinion they cannot be under- estimated when diagnosing oral and maxillofacial disease. Patients are better informed and better educated with CBCT imaging and a visual presen- tation with virtual implants in the patients’ own anatomy increases case acceptance. I rely on 3-D technologytoplanandplacesafe,preciseimplants. With the benefit of CBCT imaging I have been able to expand the scope of services I provide and in- creased the geographic reach giving our patients access to the advanced technologies and produc- ing optimal treatment outcomes. I have become proficient in Guided Bone Regeneration, Computer Assisted Guided Implant Surgery and, along with CEREC CAD/CAM technol- ogy, gained complete control over the prosthetic replacement of missing teeth. Restoring implants have been a part of my practice since 2000 but Iaddedthesurgicalphaseoftreatmentin2009with the purchase of my GALILEOS in-office CBCT unit. I do treatment planning and treatment differ- ently since implementing the use of these tech- nologies and this shift in approach has resulted in positive patient experiences. Patients benefited with correct diagnosis and treatment plans with safer, less invasive treatment experiences. I have grown to greatly appreciate the powerful tool that CBCT imaging is and its impact on my practice. CBCT and the 3-D difference advance the multi- factorial approach to treating the decimated den- tal patient. I have been fortunate to invest in my patients’ and my personal wellbeing as an early adopter of the use of 3-Dimaging.Eachmemberof our team brings a unique skill set and we provide a level of care unmatched in the traditional dental practice. When constructing a treatment plan it is imper- ative to interview the patient to verify their desires as opposed to their needs. I will educate while ob- taining informed consent and thoroughly assess all risk factors that could impact the treatment outcome. Psychological evaluation for unrealistic expectations and the ability to comprehend their existingconditionandwhatisnecessarytoimprove their dentition can impact whether or not to treat the patient. The imaging and interview will help me decide whether or not I accept the case for treat- ment. I make each patient my first priority and spend as much time as necessary to explain find- ings, present options and answer any questions. The following cases are examples that clearly illustrate the 3-D difference and how this technol- ogy can benefit all dental practices. What is signif- icantisthatpriortoobtaininganinofficeGALILEOS CBCT scanner I did not have the confidence to pro- vide these services in my office and had to refer these cases to specialists. _Case 1—The reluctant patient This case is an example of a case that I would have been foolish to treat without the benefit of 3-Dimagingandwouldhaveplacedanunnecessary risk of injury to the patient due to the anatomical limitations present and the desires of this patient. A 52-year-old male patient, presented to my office for an implant consultation on the 5th of November 2013.Hewasingoodhealthandhismedicalhistory revealed he has controlled hypertension. There were no contraindications for dental treatment. Patient made it clear that he would like to replace multiple missing teeth in a fixed manner only but he is very anxious about having dental surgery to replace these four missing lower right quadrant teeth. His last dental treatment was for the removal of tooth #27 (over 6 months before) and concomitant bone graft to preserve alveolar ridge and prepare for its replacement. In addition he was reluctant to be ‘knocked out’ to facilitate any surgery and declined additional bone grafting procedures. We began by completing the conventional clin- ical and radiographic examination. Clinically his ridgeappearednarrowintheareaoftooth#28and #29, but crestal tissue was keratinised (Figs. 1–3). The patient travelled well over an hour to visit our 08 I CAD/CAM 1_2016 Fig. 8 Fig. 10 Fig. 9 CAD0116_06-18_Ramirez 21.01.16 11:02 Seite 3 CAD0116_06-18_Ramirez 21.01.1611:02 Seite 3